Would you boast about dangling your baby over the edge of a balcony to please your fans?

It’s really no different from what homebirth advocates do when they boast about a breech homebirth to impress their peers. Oh, wait; it is a bit different. A breech homebirth is far more dangerous than dangling your baby off a balcony.

Yesterday, the twitter feed on #homebirth was filled with worshipful retweets of a frank breech delivery at homebirth (“Graphic!”), breathlessly subtitled “A frank breech at home, against all odds.”

No less an authority than Gina Crossly-Corcoran, The Feminist Breeder, weighed in with:

This is one of the coolest things you’ll ever see. A graphic video of a frank breech homebirth …

… [T]he more contraindications you have to homebirth, the more prestige you will get from having a homebirth…

In the case of homebirth advocates, it’s not that they are unaware of the risk. They do it and then publicize it specifically because they know about the risks but wish to preen within a subculture that admires taking a dare more than ensuring a safe outcome.

The next time you see a blog post, tweet, or homebirth video boasting about twins, or footling breech or premature birth at home, keep that in mind. These don’t demonstrate that the risk taking behavior is safe. They’re no different than boasting that you drove home drunk and stoned and made it there without killing yourself.

QED!

Why was the mother chortling that she defied the odds? I suspect the mother is referring the odds of having a breech vaginal delivery in the face of a massive amount of evidence that it is a dangerous, selfish, stupid choice. She defied those odds all right.

How about the odds that the baby might die or suffer a serious injury? She defied those odds, too, although considering the typical ignorance of homebirth advocates, she probably had no idea what they were.

According to this Medscape article on breech, discussing the outcome of the Hannah study:

The composite measurement of either perinatal mortality or serious neonatal morbidity by 6 weeks of life was significantly lower in the planned cesarean group than in the planned vaginal group (5% vs 1.6%, P < .0001). Six of 16 neonatal deaths were associated with difficult vaginal deliveries, and 4 deaths were associated with fetal heart rate abnormalities. The reduction in risk in the cesarean group was even greater in participating countries with overall low perinatal mortality rates as reported by the World Health Organization. The difference in perinatal outcome held after controlling for the experience level of the obstetrician.

And that’s in the hospital with every possible type of emergency assistance available.

How dangerous is breech homebirth?

Consider the verdict of Marc J. N. C. Keirse MD, DPhil, DPH, FRCOG, FRANZCOG, one of the leading exponents of breech vaginal birth and an editor of the journal Birth, the de facto journal of the natural childbirth movement. Dr. Kierse shared this view in a commentary bemoaning the impact of the Hannah breech trial (which found that breech increases the risk of neonatal death) in promoting C-section for the delivery of breech babies.

Home birth is a well-established recipe for disaster for a baby in breech presentation and contrary to any sensible guidelines that have ever been developed.

It’s hard to get more definitive than that.

All in all, it’s an object lesson in the ignorance, narcissism and immaturity of homebirth advocates. Michael Jackson did something incredibly stupid when he dangled his baby over a balcony, but, in reality, the odds that he would injure or kill the baby were very low. This mother did something far more stupid in attempting a breech homebirth; the odds that the baby would be permanently injured or die were high.

At least Michael Jackson did not boast about his stupidity, but then again, he probably didn’t care whether The Feminist Breeder and her ilk thought that risking a baby’s life is “cool.”

Amy Tuteur, MD

Dr. Amy Tuteur is an obstetrician gynecologist. She received her undergraduate degree from Harvard College in 1979 and her medical degree from Boston University School of Medicine in 1984. Dr. Tuteur is a former clinical instructor at Harvard Medical School. She left the practice of medicine to raise her four children. Her book, Push Back: Guilt in the Age of Natural Parenting (HarperCollins) was published in 2016. She can be reached at DrAmy5 at aol dot com...
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